For my first article at Authentic Medicine, I’ll reference a recent article I published at as I think the concept is important for many of us.  The article begins:

The FIRE (financial independence, retire early) movement is hot, and even now, many physicians advocate for its benefits. The concept is usually to work hard and live frugally to the point that full retirement is available in one’s forties. Just do an internet search for “physician” and “FIRE” and you’ll see what I mean.”

The article goes on to mention that there are some negatives to a FIRE philosophy- a perhaps unnecessary continued strategy of delayed gratification after the many years of school and residency being one.  It also mentions that likelihood that being “retired” for four or more decades may not be either financially or mentally healthy.

As an alternative, the article suggests a FIRO approach-which is financial independence, retirement optional.  It suggests that working longer as a physician and/or changing careers may lead to more long term satisfaction and financial security than actually retiring early.  Along these lines:

I think taking on a FIRO strategy is a good way to prevent physician burnout. It involves a commitment (hopefully early in one’s career) to be able to change or modify your day to day life within 20 years of leaving training (coincidentally, it fits with getting the kids launched). A good FIRO strategy would include living at least a little below one’s means and having a disciplined approach towards investing for the long term. It means making sure that all the other financial issues are covered on an ongoing basis.”

A number of physician choices to practice part time and do other things (Doctors without Borders, teaching in Africa, military service in the Reserves) are discussed as FIRO choices. The article concludes:

Taking a FIRO strategy leaves the second half of life more interesting and perhaps exciting. A physician might just decide that they like practicing medicine at that point and continue along. But knowing that they have the option to spend their time in a different and hopefully meaningful way should provide a better path to their future.

I hope you find this concept both interesting and a potential strategy with your career.

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Steven Podnos MD, CFP

Steven Podnos MD CFP attended the University of Florida College of Medicine and trained in Internal Medicine, Pulmonary and Critical Care Medicine at UT Southwestern in Dallas Texas. He moved back to Florida with his physician wife (ENT) and raised a family while practicing Pulm/CC medicine for over twenty years. During that time, he also started and ran a Hospitalist program for several years. In 2002, Steve began a slow transition towards having a Fiduciary Fee Only Financial planning practice-at first just for friends and family. As the practice grew, he transitioned out of full time medical practice to full time financial planning. Dr. Podnos joined the US Air Force Reserve in 2008 as a critical care physician and flight surgeon. He deployed twice to Landstuhl Army Hospital in Germany as an intensivist during the Afghanistan war in 2009 and 2010, and as a critical care air transport (CCATT) physician in Okinawa in July 2018. His firm, Wealth Care LLC now serves approximately 100 physician families nationwide and another fifty non physician families with both financial planning and wealth management. He is a staunch advocate of independent medical practice, believing that the corporatization of medicine and Electronic Medical Records are both harmful to physicians. 

  2 comments for “FIRO, not FIRE

  1. Bridget Reidy
    July 14, 2019 at 6:44 pm

    My preferred approach would be work less now, do the stuff that makes you proud of what you do, take care of yourself, and enjoy life the best you can. The future is unpredictable, and a certain amount must be spent on the higher living expenses of being able to do all we do. Going to the laundromat is quite draining and time consuming, as is cooking from scratch and commuting from the cheapest suburb. We can’t cancel patients when our old cars need repairs, and vacations and occasional weekends off are essential, never mind more fun when you’re young.

    As a single parent I used to worry that I wasn’t funding a pension, but then I noticed the homebound in senior subsidized housing were happier than the ones in isolated mansions who despite or because of paying through the nose, complained constantly about their caregivers. If society doesn’t want to pay me for all the necessary work of primary care, I’ll have no guilt about using any safety net someday. Meanwhile living in a van could be really fun if I have my health left when Social Security kicks in. Doctors without Borders doesn’t need anyone who can no longer work like a young buck in deplorable conditions.

    I assume the banks are behind this concept. They love physicians, customers with no time to look into how much they take.

  2. Frank Savoretti, JD, MD
    July 13, 2019 at 2:20 pm

    Exactly! I am 66 years old, love my work in Primary Care Internal Medicine and achieved “Financial Independence” many years ago yet continue to take care of my patients because there is no other activity that is so gratifying! Have been in the “F… Y…” position since the turn of the century which is quite liberating and makes working fun. See John Goodman’s monologue in the film “The Gambler” for excellent advice.

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